Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Ability of the Third-Generation FloTrac/Vigileo Software to Track Changes in Cardiac Output in Cardiac Surgery Patients: A Polar Plot Approach.
To evaluate the ability of the third-generation (3.01) of FloTrac/Vigileo monitor (Edwards Lifesciences, Irvine, CA) to follow variations in cardiac output (∆CO) using the new polar plot approach. ⋯ Third-generation FloTrac/Vigileo software still lacks the accuracy to reliably detect changes in cardiac output (∆CO) in cardiac surgery. Improvements to FloTrac/Vigileo CO algorithm and software still are needed in this particular setting.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Randomized Controlled TrialEfficacy of Perioperative Oral Triiodothyronine Replacement Therapy in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting.
The aim of this study was to assess the effects of oral triiodothyronine (T3) therapy on postoperative thyroid hormone concentrations, hemodynamic variables, and outcomes. ⋯ Oral T3 therapy significantly attenuated the postoperative decline in T3 concentrations in patients undergoing off-pump coronary artery bypass graft surgery. The lack of apparent clinical benefit merits further investigations in patients with reduced cardiac performance.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Comparative Study Observational StudyPrediction of Responsiveness to an Intravenous Fluid Challenge in Patients After Cardiac Surgery with Cardiopulmonary Bypass: A Comparison Between Arterial Pulse Pressure Variation and Digital Plethysmographic Variability Index.
Arterial pulse pressure variation (PPV) and digital plethysmographic variability index (PVI) have been proposed to predict fluid responsiveness during anesthesia and in critically ill patients. The present study aimed to compare the clinical utility of PPV and PVI in predicting fluid responsiveness after elective cardiac surgery. ⋯ PVI is not discriminant and probably inaccurate to predict fluid responsiveness after elective cardiac surgery. PPV could be of potential interest after exclusion of patients with a low perfusion index and right ventricular dysfunction.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Comparative Study Observational StudyComparison of Electroencephalography and Cerebral Oximetry to Determine the Need for In-Line Arterial Shunting in Patients Undergoing Carotid Endarterectomy.
To compare cerebral near-infrared regional spectroscopy (NIRS) with the 12-lead electroencephalogram for the detection of ischemia during carotid artery clamping for carotid endarterectomy (CEA). ⋯ A decrease in rSO2 during carotid cross-clamping for CEA is associated with EEG-determined need for shunting, but the positive predictive value is low. Using the above cutoffs in the current series would have resulted in an increase in the shunt rate by approximately 20% when it was not indicated by EEG.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Observational StudyEvaluation of the Impact of a Quality Improvement Program and Intensivist-Directed ICU Team on Mortality After Cardiac Surgery.
Quality improvement is an important pursuit for critical care teams. ⋯ Appointment of an intensivist-directed team model and introduction of quality improvement interventions were associated with decreased mortality after cardiac surgery.